Different vault outcomes following implantable collamer lens implantation in eyes with ciliary body cysts: a case report

Ciliary body cysts are common incidental findings during preoperative screening for implantable collamer lens (ICL) implantation. Although their presence is generally not considered a contraindication to surgery, cysts extending into the ciliary sulcus may influence haptic seating. The potential contribution of cyst morphology to postoperative ICL behavior remains insufficiently described. We report two myopic patients with ciliary body cysts protruding into the ciliary sulcus who underwent posterior chamber ICL implantation. Preoperative ultrasound biomicroscopy (UBM) was used to evaluate cyst anatomy. Case 1 had a single, qualitatively thin-walled, unilocular cyst and achieved an adequate postoperative vault of 445 μm at 3 months. Postoperative UBM showed a flatter cyst contour at the haptic–cyst interface. Case 2 had two adjacent, relatively thick-walled, multiloculated cysts and developed a persistently low vault, reaching 158 μm at 15 months. Postoperative UBM showed that the cysts maintained a rounded contour and appeared to be associated with posterior displacement of the haptic. These two cases suggest that cyst morphology may be one of several factors associated with postoperative ICL vault in eyes with sulcus-involved ciliary body cysts. Detailed preoperative UBM assessment of cyst structure and sulcus anatomy may be useful for individualized surgical planning and postoperative follow-up. Larger studies are warranted to determine whether specific morphologic characteristics of ciliary body cysts are associated with postoperative ICL haptic behavior and vault outcomes.